P04.40 — Newborn affected by maternal use of unspecified drugs of addiction
Is P04.40 billable?
Yes, but P04.40 is an unspecified code. P04.40 is a valid, billable ICD-10-CM code for encounters from October 1, 2026 through September 30, 2027. However, P04.40 is an unspecified or catch-all code. Payers apply additional scrutiny to unspecified codes and many deny them when the medical record supports a more specific option, so check the documentation before selecting P04.40 — the more specific alternatives are listed below.
P04.40 at a glance
| Code | P04.40 |
|---|---|
| Description | Newborn affected by maternal use of unspecified drugs of addiction |
| Billable | Yes |
| Code set | ICD-10-CM FY2027 |
| Valid for encounters | October 1, 2026 – September 30, 2027 |
Which MS-DRGs does P04.40 group to?
P04.40 sits in MDC 15 and helps define the logic of 1 MS-DRG (version 44, FY2027). Which one a stay actually groups to also depends on procedures and secondary diagnoses.
- 794Neonate with Other Significant Problemsmedical
How is P04.40 listed in the Alphabetic Index?
These are the routes through the Alphabetic Index that lead to P04.40. They show the wording a clinician may have documented, which often differs from the Tabular description.
- Newborn › affected by › drugs of addiction (infant) (liveborn) (singleton)
- Absorption › drug NEC › addictive › through placenta
Code first — inherited from P04
The underlying condition below must be sequenced before P04.40. P04.40 describes a manifestation and cannot be the principal or first-listed diagnosis.
- any current condition in newborn, if applicable
Excludes2 — not included here — inherited from Chapter 16
The conditions below are not part of P04.40, but a patient may have both at the same time. When documentation supports it, P04.40 and the excluded code may both be reported.
Excludes2 — not included here — inherited from P04
The conditions below are not part of P04.40, but a patient may have both at the same time. When documentation supports it, P04.40 and the excluded code may both be reported.
- congenital malformations (Q00-Q99)
- encounter for observation of newborn for suspected diseases and conditions ruled out (Z05.-)
- neonatal jaundice from excessive hemolysis due to drugs or toxins transmitted from mother (P58.4)
- newborn in contact with and (suspected) exposures hazardous to health not transmitted via placenta or breast milk (Z77.-)
How long has P04.40 existed?
P04.40 first appears in FY2019.
Derived from the official order files for FY2016–FY2026. FY2017 and FY2020 publish no order file, so those years are not covered.